Making Choices

From the moment we get up in the morning, we begin making choices: shower or brush teeth first, coffee or tea, what to eat for breakfast, what to wear, and what’s on the agenda for the day. Not only do we have choices to make throughout each day, there are even bigger ones to think about such as where to take a vacation, how to spend/save money, when to start a family, what kind of job or career do you want, and where to live. Making individual choices that are right for you is a basic human right. It is also empowering.

Autistic individuals may struggle to make choices because of challenges with executive function, difficulty communicating preferences, or not being able to recognize there is an opportunity to make a choice. They may lack the understanding of the potential consequences of their choices. No matter what challenges an autistic person has, they should be supported in making their own choices and taught choice making skills. This will lead to greater independence, happiness, and well-being. Providing choices helps an autistic person to learn about themselves, express their interests, feel safe, in control, and prepared.

Luce Greenwood, autistic advocate, says:

Having other people take choices from us can have such a negative impact on autistic people. It can make us believe we are useless and destroy our confidence. It can even lead to us putting ourselves in dangerous situations just to prove ourselves. 

Autistic people are more likely to work until they are past burnout, agree to activities and projects they don’t have the capacity for and even do things that are, in hindsight, quite dangerous. I myself have hung out with toxic people to prove I can be sociable, have hiked across the moors at a late hour to prove I do have a sense of direction and have worked seven-day weeks to prove I’m a good worker, often making myself ill in the process. 

Every person wants to feel empowered. Because autistic individuals struggle more with communication and social skills, they may rely more heavily on protest behaviors to assert themselves and their wishes. When adults can see the disparity between need and the ability to independently gain that need, they can begin to provide the tools to support autistic individuals.

What do I need to know about choice making?

The skill of choice making is composed of two parts – choosing and requesting. This skill requires a person to make a choice first. Before working on choice making, make sure the person is comfortable requesting items that are not directly in sight. If they need additional support in making a request, have a look at this tool.

When combining choosing and requesting, some autistic individuals may have difficulty. Get to know and understand the person you are working with. Are they overwhelmed by several choices? Do they need to see the actual items in order to make a choice? Do they need a visual support in order to choose?

How can I offer choices?

Think about using structured choice, which means to present an abundance of specific choice opportunities throughout the day. Offer choices for as many things as possible – objects, activities, locations, foods, drinks, toys, actions, and people. Choices can be offered multiple times throughout the day. Here are some ideas for giving choices:

1. Offer between two and four choices. More than four choices can be overwhelming and too much to process.
2. Use visuals to present choices. Set out objects, use photographs, or show written lists (ex. menu items, movie listings).
3. Keep choices simple and concrete. 
4. Offer choices in the moment. What does the person want to do right now?
5. Honor the choice that is made. When a person makes a choice, follow through with their request.

What are some things I can do to provide choices and build this skill?

Offering Two Items

• Present two objects to choose from. Make sure one of those objects is on that the child prefers. This can be done for any activity during daily routines such as mealtimes, snack time, or getting dressed.
• Hold up the two items so that the child can see them. Ask, “Which one do you want?”
• If the child makes a choice, give them the item right away.
• If they don’t respond, repeat the question and wait a few seconds before responding. Sometimes we jump in too soon.
• If they don’t respond, this choice may not be motivating for them because they don’t want either item.
• Once the child can choose from an actual object, you can move to a visual support such a photograph, drawing, or icon.

Offering Two Items with a Visual Support

• The idea here is to help the child recognize that a picture can represent the item they want to choose. Make sure the actual item is out of reach or they may just grab it without making a choice.
• Place a picture of two items in front of a child and ask, “What do you want?”
• If the child responds by indicating a choice either by handing over the picture, pointing to the picture, or communicating their choice verbally or through other means of communication, give them the object.
• If the child doesn’t respond, try again at another time with different choices for toys, games, or activities or during a different routine.
• Practice this skill with different items and in different settings to promote generalization. Vary the choices, don’t use the same objects or activities each time, and practice the skill in a different setting where the options are different.

Using a Choice Board

• Provide the child with a series of visual supports. These can be photographs, icons or drawings printed and velcroed to a board or folder so that it can easily travel with the child. The idea here is that the child is making a choice with only the visual support and can’t directly see the actual items, objects, or activities that are offered.
• This can involve one or more choices. Include one obvious preference and one activity that the child does not enjoy that much or include two preferences.
• Place the choice board with the pictures in front of the child. Ask the child, “What do you want?”
• If the child responds by indicating a choice either by handing over the picture, pointing to the picture, or communicating their choice verbally or through other means of communication, give them the object or start the activity.
• If they don’t respond, this choice may not be motivating for them. Try again at another time with different choices for toys, games, or activities or during a different routine.

What can we do to provide choices in the school setting?

Here are some suggestions for providing choices at school. (from the Autism Hub, Queensland Government, Australia)

1. Look at your daily/weekly plan. Identify times where you can offer choices. Focus on times or activities where engagement or participation can be improved.
2. Limit the number of choices provided. A choice of two is a good starting point.
3. Before offering the choice, ensure both options are available and they are motivating to the student.
4. Provide the choice options to the student e.g. ‘Do you want to work at the group table or by yourself?’
5. State the student’s choice e.g. ‘You have chosen to work at the group table.’
6. Follow through e.g. direct the student to the group table.

Examples of choice making opportunities at school:                                                                                                                         

• sit at the group table or by yourself
• write in your notebook or type on the computer
• use a pencil or pen
• from the list of topics, choose one
• complete 3 of the 5 problems on the list
• choose how many items to complete before having a break
• choose what order you want to complete the 3 worksheets
• choose either the teacher or a classmate to check your work
• when you want assistance, either raise your hand or use the help card
• stand at the front or the back of the line
• complete the worksheet by yourself or with a classmate.

Being able to make choices takes practice so provide many opportunities to build this important independent, empowering skill. Everyone wants to be their own person, to be able to pursue their own interests and desires. Luce Greenwood says, “I want to be seen for the talents I have, the skills I have and the person I am. I also want my autism to be seen as a part of who I am, and not a hindrance to becoming an independent adult.”

References

Greenwood, L. (May 3, 2024) Let Autistic People Make Their Own Choices! Thinking Person’s Guide to Autism

McNeil, C. (January 24, 2024). Leading with Choice: Honoring and Empowering Autistic Children. Autism Parenting Magazine

Queensland Government Autism Hub. (January 25, 2022). Choice Making.
https://autismhub.education.qld.gov.au/resources/functional-behaviour-assessment-tool/help/choice-making

Virginia Commonwealth University’s Autism Center for Excellence (VCU-ACE). April 2021. Skill 12 – Choice Making.
https://vcuautismcenter.org/documents/communicationandsocialskills/Skill_12_Choice_Making.pdf